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Can't Get In To See Your Doctor? Many Patients Turn To Urgent Care

Posted By NPR, Thursday, March 10, 2016

Though the majority of Americans have a primary care doctor, a large number also seek treatment at urgent care centers, statistics show. For many people, the centers have become a bridge between the primary care doctor's office and the hospital emergency room.

Urgent care is not meant for life-threatening emergencies, such as a heart attack, stroke or major trauma, doctors say. But it is designed to treat problems considered serious enough to be seen that day — conditions like a cut finger, a sprained ankle, severe sore throat, or the sort of infection 25-year-old Dominique Page recently experienced.

Page, who lives in Los Angeles, suspected she had a bladder infection when she woke up that morning. Instead of calling her primary care doctor, she headed straight to the nearest urgent care clinic.

"I knew if I made an appointment at my doctor's office, it wouldn't be for today," she explains. "Their appointments are usually booked."

Page's decision seems pretty typical. In a recent poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, most people reported going to urgent care because they believe it is more convenient and takes less time than going to their regular doctor. One in 5 said that at least once in the past two years, they were unable to see their regular doctor when they needed medical care, mostly because the doctor didn't have any available appointments, the office was closed or the doctor was out of the office.

Page went to Reliant Immediate Care, adjacent to Los Angeles International Airport. Walk-in patients are welcome, and the clinic is open 24/7.

"We don't even know where the key to the front door is," says the clinic's medical director, Dr. Max Lebow, "because at least in the 10 years that I've been here, we've never closed the front door."

For years, Lebow says, he worked in a hospital emergency room, where he saw lots of people who "never should have been in the ER in the first place." In his experience, he says, maybe 20 percent of the ER patients are admitted to the hospital, which means that about 80 percent are sent home.

For years, Lebow says, he worked in a hospital emergency room, where he saw lots of people who "never should have been in the ER in the first place." In his experience, he says, maybe 20 percent of the ER patients are admitted to the hospital, which means that about 80 percent are sent home.

National statistics suggest an even higher percentage tend to leave the ER without needing a hospital stay. Of those patients, Lebow says, probably 75 percent could be seen in a less intensive setting — like an urgent care center.

After tests, Lebow confirmed that Page had a bladder infection and prescribed antibiotics. Page was relieved to have a diagnosis and treatment. She was in and out in less than an hour, she says, and — even better — her visit cost far less than going to a hospital ER, which charges a "facility fee" just to walk in the door.

That fee — which typically ranges from $300 to $500 — helps cover the cost of having on hand, 24/7, all the equipment and staff needed to treat even the most extreme emergencies, explains Dr. Roger Hicks, an emergency medicine doctor on the governing board of the Urgent Care Association of America.

According to a recent review from the National Center for Health Statistics, visits to the ER can easily run more than $1,000 for adults. The average visit to an urgent care center, in contrast, hovers around $150.

Nationwide there are now more than 7,000 urgent care centers across the country, and Hicks calls the industry's growth in the past couple of decades "explosive." He says patients tell him they appreciate the cost savings and convenience — most urgent care centers are open in the evenings and on weekends and holidays. In large, urban areas, many are open around the clock.

Most centers take private insurance and Medicare, although some don't take Medicaid; Hicks says Medicaid reimbursement doesn't cover the cost of providing care. Uninsured patients have to pay cash.

In our poll, most patients said they found the cost of their visits "reasonable." And the majority — 75 percent — rated the care they received as "excellent" or "good."

But 25 percent of those polled described their care at an urgent care center as just "fair" or even "poor."

One of those poll respondents was 31-year-old Syntyche Toniy, who lives in Orlando, Fla. Toniy went to her local urgent care center after cutting her hand while gardening, and says she found the process there "disorganized."

After registering at the front desk, she waited another two hours before seeing a doctor, who then sent her to the hospital emergency room anyway — for stitches

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Urgent Care Keeps Growing for Patient needs

Posted By Press of Atlantic City, Thursday, February 18, 2016

When Sanai Mays, 5, of Egg Harbor Township, woke up with a sore throat Wednesday morning, her father tried to figure out where to take her to get it checked out.

“I was on the phone with my wife and I told her I was either going to take her to the doctor or to urgent care, and my daughter said that she wanted to go to urgent care, ” said Mike Mays, 33, of Egg Harbor Township, as he spoke with a nurse at AtlantiCare’s Urgent Care Center on English Creek Avenue. “I have four children, so we are constantly in and out of this urgent care.”

Mays is one of the growing number of people using urgent care facilities over hospital emergency rooms for non-emergency care.

Fueled by frustration over long waits in the emergency room for non-emergency care, and a reduction in available primary care appointments that often means patients wait weeks to see their doctor, a new growth spurt for the urgent care industry began in the mid-1990s and continues, according to a report by the American Academy of Urgent Care.

Since 2008, the number of facilities across the country has increased from 8,000 to 9,300, the report said.

“She wants to come here over the hospital,” Mays said. “As far as my insurance is concerned, urgent care is a $5 copay, while the emergency room is a $50 copay.”

AtlantiCare offers 10 urgent care locations around South Jersey, while Shore Medical Center has three locations. In July, Inspira Health Network opened an urgent care facility on West Landis Avenue in Vineland. The facility is Inspira’s first in Cumberland County.

“We’ve seen continued growth annually,” said Jatin Motiwal, vice president of AtlantiCare Physician Group, adding that over the past five years, AtlantiCare has seen an increase of about 25 percent in patients at urgent care facilities.

Urgent care facilities provide care for a variety of ailments, including sports injuries, flu, respiratory infections, minor lacerations, fractures and sprains, and many other general illnesses and injuries.

Shore Medical Center opened its first urgent care center in 2012 in Northfield, and has since opened two more locations in Atlantic City and Mays Landing, said Mark Stephens, administrative director of Shore Physicians Group.

“We are seeing the biggest impact with millennials — they think that they are bulletproof and they don’t want to sit in an emergency room for four hours,” Stephens said.

Health care, especially the concept of urgent care facilities, has changed a lot of over the years, said Dr. Robert Holtzin, a staff member at AtlantiCare Urgent Care in Egg Harbor Township. AtlantiCare opened its first urgent care facility in 2003.

“It was a word that was not known in the area when we opened this facility,” Holtzin said. “The only people that showed up at the start were other staff members wishing us well. Over the years, the amount of patients we saw continued to grow. Now urgent care has become synonymous with care after hours.”

Urgent care centers reported an average of nearly 14,000 patient care visits in 2014, according to a report by the Urgent Care Association of America. Facilities handle an average of four patient care visits per hour and 49.8 visits per day, according to the report.

“Urgent care is growing across the country because it provides patients a much-needed option for acute illnesses or injuries that aren’t life-threatening,” said Dr. Robert Kimball, president of the board of directors for the association. “Urgent care serves as a bridge between the emergency room, which can be too costly and time-consuming for common illnesses and non-life threatening episodic events, and primary care physician clinical services.”

The demand for urgent care-type facilities continues to grow, Kimball said

“Demand for urgent care is rapidly increasing due to the convenient hours that fit today’s patients’ busy schedules, and because it is a more affordable option than the emergency rooms or freestanding emergency rooms for less serious situations,” Kimball said.

Urgent care conjures up positives images for Sanai Mays, her father said.

“She wants to come here over the hospital. She hears hospital and thinks of needles; when she comes here she thinks popsicles and stickers,” Mays said, while his daughter stood next to him smiling and eating her popsicle.

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20 Things to Know About Urgent Care | 2016

Posted By Becker's Hospital , Monday, February 15, 2016

As healthcare shifts toward the outpatient arena, urgent care centers remain popular with patients and consumers looking to receive convenient and affordable treatment for minor conditions, imaging and blood tests.

Highlighted below are 20 facts and statistics to know about the urgent care market.

1. There are nearly 7,100 urgent care centers in the U.S., according to the most updated number from the Urgent Care Association of America. Included in this number are urgent care centers verified manually by UCAOA and provide full-service urgent care medicine (X-ray, lab, extended hours). There is no other national database, since federal registration is not required. 

2. Eighty-nine percent of urgent care centers said patient visits increased in 2014, the survey found.

3. The survey also found most (87 percent) urgent care centers acquired or built a new location in 2014, and 91 percent anticipated growth in 2015.

4. According to the UCAOA 2015 Benchmarking Survey, the most common urgent care center locations include:

  • Shopping centers/strip malls (34.1 percent)
  • Freestanding buildings (33.2 percent)
  • Mixed-use buildings (13.6 percent)
  • Medical offices (19.1 percent)

5. One average, current urgent care clinics have been in operation for seven years.

6. Urgent care clinics average seven exam/treatment rooms.

7. At most urgent care centers (90 percent), the wait time to see a provider is 30 minutes or less, and total patient throughput is 60 minutes or less at 84 percent of urgent care centers.

8. Nearly all urgent care centers (96 percent) operate seven days a week and are open at least 4 hours per day, according to the UCAOA 2015 benchmarking survey.

9. Eighty-seven percent of urgent care centers provide urgent or episodic care exclusively, whereas 13 percent provide urgent and ongoing primary care or specialty urgent care.

10. More than half (66 percent) of urgent care patients have an outside primary care physician.

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Why Do We Continue Using the ER for Care

Posted By US Health, Tuesday, January 5, 2016

Access to health care is one of the hottest topics in society today. As a nation, we have worked feverishly to find the perfect health system that ensures our citizens can get medical care whenever it's needed.

In a society that gets its news 140 characters at a time, we are now a generation of immediate information, training and activity. This extends to the health care system more than ever in our history. Finding ways to allow immediate, convenient access to medical care now includes an olio of options, from the  doctor's office and urgent care centers to clinics in large retail chains. It also, of course, includes the old standby: the emergency room. With so many choices, it can be difficult to know how best to access medical care in the U.S. today.

According to the Centers for Disease Control and Prevention, ER visits increased by 20 percent in the first decade of the new millennium. That translates to about 136 million visits per year. One in 5 Americans will visit the ER at least once annually. Of those trips, only 12 percent will result in admission, meaning many of those visits, as many as 65 percent, are deemed unnecessary. The result is very costly in terms of both time and money. 

ER visits are about four times as expensive as other ambulatory visits and take an average of four to five hours versus the usual one-hour visit in other venues. Billions of dollars in health care costs, along with 65 percent waste and endless hours of work and school time lost occur as a result. 

So why do we continue using the ER for care? Convenience, mainly. For children, about 75 percent of their visits occur on nights and weekends, when the primary care physician is not open. Most of these visits are related to respiratory illnesses. Most adults show up for injuries, certainly unplanned and not likely to fit into a scheduled appointment. 

Other more optimal options exist for care. The most important health care relationship remains the bond between the patient and primary care provider, or PCP. This type of medical home is critical to having a long-term health plan versus one based on crisis intervention. However, there are several limitations to this time-honored method of health care delivery: Inconvenient hours, lack of on-site diagnostics and off-site pharmacy requirements make one-stop shopping in this setting difficult, a departure from what we've come to expect in the supermart world of today. 

Several alternatives exist to the PCP office and ER. Urgent care centers have become a staple across the country. While not open 24/7 like the ER, evening and weekend hours make them an attractive option. These venues usually have a 30- to 60-minute wait time and an average bill of $60. Limited diagnostics are often available, such as strep tests, urinalysis and plain X-rays. Generally staffed by physicians or nurse practitioners, these venues are great for common illnesses such as colds, flu, low-grade fever, earaches, sore throat and mild rashes, to name a few. 

New to the market are the chain store clinics. Originally started as a way to entice customers into the store, these clinics are quickly becoming an alternative to the PCP and urgent care centers. Many of these clinics can diagnose and manage acute illnesses, and supply first-aid items, durable medical equipment and even fill prescriptions right in the store. In addition, significant efforts in detecting and preventing chronic illnesses (think: vaccines) can be done in this setting. These clinics definitely cater to the one-stop shopping lifestyle that a busy world desires and requires.

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Stay Healthy During the Holiday

Posted By Reader's Digest, Friday, December 18, 2015

Keep the focus on fun, not food
Most holidays are associated with certain foods. Christmas at your house might not be the same without your aunt's green been casserole, but that doesn't mean food has to be the main focus. Instead, throw yourself into the other rituals a holiday brings, whether it's caroling or tree trimming.

Modify your eating times so that they jive with your relatives'.
Do your in-laws' meal schedules fly in the face of yours? Here's how to compromise: Say they wake up later than you do and serve a late breakfast at 10:30. Then they skip lunch and serve Christmas 'dinner' at 3 p.m. To keep your blood sugar steady without overdoing it on calories, have an early-morning snack (such as a piece of whole-grain toast) before your relatives rise and shine. Their late breakfast will count as your 'real' breakfast, plus some of your lunch. Enjoy the 3 p.m. meal - but don't overdo it! - and have a small snack at around 8 p.m.

Cut down your own Christmas tree.
Rather than buying a tree from a roadside lot where the trees have been drying out for weeks, visit a tree farm that allows you to cut your own. It will be fresher and probably less expensive than they are at the lot. You'll burn off calories and combat some of the blood-sugar effects of the sugar cookie you snuck by traipsing around the grounds in search of just the right tree. And your family will have one more fond holiday memory to look back on.

Make the change!
The habit: Staying physically active during the holidays.
The result: Gaining less weight over the years.
The proof: A study conducted by the U.S. government found adults gained, on average, more than a pound of body weight during the winter holidays - and that they were not at all likely to shed that weight the following year. (That may not sound like a lot now, but it means having to buy roomier pants after a few Christmases pass.) The good news is that the people who reported the most physical activity through the holiday season showed the least weight gain. Some even managed to lose weight.

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7 Ways To Access Affordable Care When Travelling

Posted By Vitals Blog , Wednesday, November 25, 2015

The last thing you want to consider when planning your vacation is what to do if you get sick or injured while traveling. Talk about a downer. A medical issue can not only derail your fun – but also wreck your wallet, if you’re not prepared.

Screen Shot 2015 11 24 at 2.07.15 PM 7 Ways to Access Affordable Care When Travelling Photo
Find affordable care wherever you travel this holiday season
Here’s how to make sure you can access affordable care, should you need it, on your next trip.

Be Organized

It sounds elementary, but many people forget to bring along their insurance card and medications in the frenzy of packing. While pharmacies today can often get records of your prescriptions, you’ll save money by not having to shell out for the same medication you had at home.

Pack a First Aid Kit

Be ready to treat common illnesses and ailments on the go. Blisters, head aches and bug bites are the typical maladies of travel. Have a small stash of bandages, alcohol swabs, ibuprofen, decongestants and other basic fixes so you can easily access them at any time.

Call Your Home Doctor

While your home doctor can’t treat you over the phone, it doesn’t hurt to call for advice. Your primary care physician should be able to answer a question or at least point you in the direction of where you should go next for care.

Try the Pharmacy

Pharmacists are a friendly bunch that are often happy to have a quick chat with you about over-the-counter remedies that can help with common ailments like upset stomachs, allergies and head colds. They can also let you know if a medication you’re purchasing will interact negatively with a drug you’re currently taking.

Call First

If an ailment needs more than an over-the-counter remedy, call your insurer to see what benefits are available to you when you’re “out of area.” Inquire about out-of-pocket costs for urgent care and retail clinics, as well as emergency care. Also ask if you’ll need pre-authorization before hospitalization.

Use Walk-in Clinics

Retail clinics and urgent care centers offer convenient care for more serious ailments and injuries, no appointment necessary. What’s more, these clinics often post prices, so you know the cost upfront. To find a nearby clinic, use a site like Vitals.com, which has information on medical facilities as well as doctors.

ERs for Emergencies Only

When a sickness or injury is life threatening, or if no other care option is available, seek out the nearest emergency room immediately. And remember that 911 is available everywhere in the US and works on cell phones with or without a data plan.

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Two flu-related deaths reported in central Iowa

Posted By KCCI , Tuesday, November 17, 2015

Watch the Video 

Officials said the two middle-aged men, age 41 to 60, are from central Iowa. 

Dr. Patricia Quinlisk, medical director of the Iowa Department of Public Health, said their deaths are unusual because of how early it is in the season and that the men weren't that old.

"These deaths are an unfortunate reminder the flu virus is circulating in Iowa, and does have the potential to cause severe illness and death," Quinlisk said.

Officials said the flu season typically peaks in February and can last as late as May. Iowa, Oregon and Rhode Island have the highest influenza activity in the U.S.

The approximately 50 Unity Point clinics and urgent care centers in central Iowa have seen a combined 28 cases of influenza since the first of October, which officials say is not a large amount, considering the state sees about 300,000 cases each year.

Flu and its complication of pneumonia cause an average of 1,000 deaths yearly in Iowa, based on CDC estimates.

At the Unity Point Clinic in Norwalk, 300 doses of flu shots are on hand, but no flu mist doses. The clinic manager said they usually have about 500 doses this year and hopes to get another delivery within the week.

Quinlisk said there have been outbreaks in eastern Iowa, but influenza has not been widespread.

“But it's coming. And especially now that we've had deaths in central Iowa, the bottom line is the flu is here, and it's going to get worse. If you haven't got your flu shot yet, now's the time to go get it,” she said.

Flu numbers can spike after the holidays begin. Quinlisk said not to wait to get vaccinated. If you get vaccinated in the next few days, you'll have good immunity by Thanksgiving.

Vaccinations are recommend for everyone 6 months of age and older and especially for those who have regular contact with people more vulnerable to the complications of flu, including babies, children with asthma and the elderly.

Symptoms of the flu include fever, headache, tiredness, cough, sore throat, nasal congestion, and body aches. Illness typically lasts two to seven days. Learn more at http://www.flu.gov

Tags:  Flu  flu shots  prevention  treatment  urgent care 

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How Healthcare Will Look With a Physician Shortage

Posted By Chicago Tribune , Friday, November 6, 2015

The Association of American Medical Colleges projects that the nation will face a shortage of 12,000 to 31,000 primary-care physicians by 2025. So it's no wonder you may be finding it harder to find a doctor or to schedule an appointment with the one you have.

What's fueling this problem? The baby boom generation pouring into older age, an aging physician workforce preparing to retire and an estimated 30 million Americans joining the ranks of the insured since enactment of the Affordable Care Act in 2010.

What that means is that you may not being seeing a doctor at all the next time you go for health care.

"The impending physician shortage is an opportunity to move to a health care model where the physician can be more of a quarterback on a team of health care providers, rather than being on the front lines," said Dr. David Gorstein, managing director of Health Innovations, a health care consulting firm in Charleston, S.C., focusing on new models of health care. It's time to look to other, more affordable and accessible settings, he said.

Here are five options for addressing shortages and reining in costs.
Retail clinics

Maybe you have a scratchy throat and suspect another cold, but there's a two-week wait to see your doctor. Or you're out of town on business or are self-employed without health insurance.

Typically located in pharmacies, groceries and "big box" stores, these walk-in clinics began cropping up in 2000 and served more than 20 million patients in 2014, according to their trade association, the Convenient Care Association. To date, they number over 1,800 in 40 states and Washington, D.C., offering lower-cost options for health services with transparent pricing, so consumers know what they are paying for.

Visits typically range from $40 to $75 and address acute conditions, such as bronchitis and ear infections, as well as provide immunizations and physicals. Usually staffed by nurse practitioners, who are highly trained registered nurses, some incorporate pharmacists into ongoing care (which is particularly valuable in medication counseling for chronic diseases like diabetes or asthma). The clinics generally accept health insurance and can send a record of your visit to your primary-care physician.

"While the care can be excellent and the wait times and cost to the patient much less than emergency rooms, it's important to understand that walk-in clinics only treat a limited list of problems," said Dr. John W. Rowe, professor of health policy and aging at the Columbia University Mailman School of Public Health. They should not be relied on as a source of ongoing care, he cautioned. Yet Dr. Don Goldmann, chief medical and scientific officer at the Institute for Healthcare Improvement in Cambridge, Mass., sees their growth as proof that they fill important needs, providing "easier access to providers and quick, convenient care."

Urgent-care centers

Although they've been around for decades, the more than 6,400 urgent-care centers in the U.S are seeing an upswing in growth (from 8,000 to 9,300 since 2008), fueled by consumer frustration with long waits in emergency rooms and for appointments with primary-care physicians. These same-day walk-in clinics focus primarily on emergency medicine for acute (but less severe) medical problems. Typically staffed by trained and licensed physicians and medical assistants, registered nurses and X-ray technicians, nearly one-third of them are hospital owned and operated.

Many offer evening and weekend hours, perform X-rays and some on-site lab tests (like urinalysis and pregnancy and strep tests) and provide procedures like suturing and casting, usually more economically and with less wait time than hospital emergency rooms. In some communities, they function as primary-care practices for some patients. One study estimated that up to 27 percent of emergency room visits could be handled appropriately at retail clinics and urgent-care centers, offering cost savings of $4.4 billion per year.

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Thanksgiving Safety and Wellness Tips

Posted By UCAOA Staff, Wednesday, November 4, 2015

UCAOA wants patients everywhere to have a safe Thanksgiving gathered around the dinner table, not an ER waiting room. But if needed, most urgent care centers are open Thanksgiving Day to conveniently and quickly treat minor injuries and illnesses – from burns or broken bones to the flu and strep throat. 

Treating Cooking Burns

Cooking injuries peak on Thanksgiving, according to the U.S. Consumer Product Safety Commission. Here are tips for treating burns if they happen:

  • First degree burn – A first-degree burn only affects the top layer of skin, and some swelling and redness may occur. These burns can generally be treated at home with a cold compress.
  • Second degree burn – A second-degree burn is moist and painful with blistering and swelling that usually lasts for at least 48-72 hours. Immediately submerge the area in cool water, then loosely wrap in sterile gauze. To avoid infection, visit an urgent care center as soon as possible.
  • Third-degree burn – A third-degree burn may be caused by steam, hot oil, grease, chemicals, electrical currents and hot liquids, and should be treated at an ER.

Preventing Foodborne Illness

Thanksgiving turkeys may contain salmonella, a bacteria which can cause food poisoning. Always thaw a frozen turkey in the refrigerator for three to seven days. Never thaw a turkey on a counter, and thoroughly wash hands and utensils immediately after they come into contact with raw meat. Also, make sure the turkey is safe by cooking the bird and stuffing to an internal temperature of 165°F. And while leftovers are always a highlight of Thanksgiving, make sure they are kept refrigerated to avoid spoiling.

 

Caring for Minor Injuries

Thanksgiving brings lots of fun – and potential for lots of injuries. Here are tips for caring for two common issues:

  • Sprained ankle from touch football game  – R.I.C.E – Rest, Ice, Compression, Elevate. Rest the injured limb, ice it with a cold pack in a cloth, compress the area with an elastic wrap or bandage and elevate the limb above the heart.
  • Minor knife cuts – Wash hands to prevent infection, then apply gentle pressure with a sterile bandage or clean cloth with the wound elevated above the heart. Once bleeding has stopped, clean it with soap and water and apply an antibiotic ointment and a bandage. If the wound appears serious, a provider at a local urgent care center can stitch the wound.

Have a lovely and safe holiday! 

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Healthy House, Healthier Body

Posted By Home Advisor - Jon Nunan, Wednesday, October 7, 2015

Though factors like exercise, lifestyle, and age certainly play a huge role in our bodies' natural immunities, your environment can also help or hurt your chances of getting sick. If your home contains one or more of these elements, you may be at risk for ailments that could have been avoided!

Mold Problems
One of the most well-known culprits in house-borne illness is mold. Generally associated with upper and lower respiratory symptoms, some estimate that up to 30% of American houses may have a mold problem. The best way to find out if your home contains toxic mold is, of course, to have it tested. Mold testing averages less than $1,350 and mold removal generally runs about $2,500.

Ventilation Issues
On a similar note, indoor air quality in this country has taken some serious hits in recent years. Probably the biggest factor in this trend is the fact that many remodels and new constructions are far more air-tight than older homes. While this is great for heating and cooling costs, when extra insulation is not supplemented with better ventilation the air-borne particles that would seep out of an older home can become trapped indoors and reduce air quality. The average cost of installing an attic or whole house fan at $890.

Radon Gas
January has been designated National Radon Action Month, and both the EPA and the U.S. Surgeon General have recommended that "all homes be tested." Aptly dubbed "the silent killer," tasteless, colorless, odorless radon gas can be extremely harmful (or even deadly) in high concentrations. The only sure-fire way to tell if your home has a radon problem is to have it tested. You can test your home yourself with a kit or hire a professional to do it for you.

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Tags:  health  Healthy living  home  home owners  mold 

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